Heart failure & cardiomyopathiesSecondary analysis
Sacubitril/Valsartan Reduces Incident Anaemia and Iron Therapy Utilization in Heart Failure: The PARAGON-HF Trial
- Secondary analysis of the PARAGON-HF randomised trial
- multicentre
- global
Authors' conclusion
Among patients with HFmrEF/HFpEF, treatment with sacubitril/valsartan resulted in modestly smaller declines in haemoglobin, lower rates of incident anaemia, and fewer new initiations of iron therapy compared with RASi.
Study context
- Population
- Patients with heart failure (HF) and LVEF ≥45% (HFmrEF/HFpEF)
- Participants
- 4,795 patients
- Comparison
- Sacubitril/valsartan vs valsartan
- Primary endpoint
- Incident anaemia
Primary result
As reported in the abstract
Hazard ratio
0.76
95% CI 0.68–0.85
P < 0.001
By group
Sacubitril/valsartan vs Valsartan
HR 0.76 (95% CI 0.68–0.85); P < 0.001
Further findings
| Outcome | Sacubitril/valsartan | Valsartan | Estimate | P value | |
|---|---|---|---|---|---|
| New iron therapy initiation | 8.1% | 10.0% | HR 0.81 (95% CI 0.67–0.97) | P = 0.026 | |
| Total HF hospitalizations and CV death, anaemia vs no anaemia at baseline · median follow-up 2.9 years | adjusted rate ratio 1.31 (95% CI 1.12–1.54) | P = 0.001 | |||
| 0.512Ratio (log scale) |
| Outcome | difference (g/dl) (95% CI) | P value | |
|---|---|---|---|
| Decline in haemoglobin · slower decline with sacubitril/valsartan | 0.1 (0.0–0.2) | P = 0.005 | |
| −0.100.10.20.3Difference, g/dl (linear scale) |
- Total HF hospitalizations and CV death, anaemia vs no anaemia at baseline: Anaemia 21.6 per 100 patient-years
- Total HF hospitalizations and CV death, anaemia vs no anaemia at baseline: No anaemia 11.5 per 100 patient-years
Treatment effect on total HF hospitalizations and CV death across haemoglobin spectrum
- Consistent across the haemoglobin spectrum
- P for interaction = 0.60
Original publication
Sacubitril/Valsartan Reduces Incident Anaemia and Iron Therapy Utilization in Heart Failure: The PARAGON-HF Trial. Eur J Heart Fail. Published 1 September 2024. doi:10.1002/ejhf.3414
Summarised from the published abstract; every number is checked against it